ABSTRACT
I. Epidemiology of Hand Eczema in the Construction Industry 390
II. Irritant and Allergic Hand Eczema in Construction Workers 392
III. Hand Eczema Among Different Types of Workers in the Construction Industry
IV. Contact Allergens in the Construction Industry 393
A. Chromate 393
B. Cobalt and Nickel 394
C. Rubber Chemicals 395
D. Rubber Gloves/Boots Allergy 395
E. Epoxy Resins 396
F. Effect of Elimination of Chromate in Cement on Allergic Contact Eczema in the Construction Industry
V. Prognosis of Hand Eczema from Cement 397
VI. Rehabilitation and Preventive Measures 397
References 398
I. EPIDEMIOLOGY OF HAND ECZEMA IN THE
CONSTRUCTION INDUSTRY
The construction industry is one of the major contributors of patients with occupational hand eczema in many countries. In Singapore, the largest number of patients attending its occupational skin disease clinic were construction
workers.1 There are few field studies on the prevalence and incidence of occupational skin disease in the construction industry;2,3,5 this is because of the difficulties in conducting field studies under the conditions of construction work. Most workers with hand eczema also had contact eczema to cement. In the Netherlands, the prevalence of hand eczema among construction workers was 7. 1% (of 112 construction workers surveyed in a population survey). In the Netherlands, workers from the construction industry were the third commonest occupational group presenting with hand eczema, after the chemical industry and metal industry.6 In a field survey of occupational eczema presented with pure hand eczema, 68% of 22 workers with irritant eczema presented with pure hand eczema.4 Cement is the most common cause of hand eczema among construction workers.1,4
In Sweden, a 1 -year-period prevalence survey of hand eczema in a population of hand eczema showed that hand eczema was prevalent in 3.6% of concrete workers.7 The 1 -year-period prevalence of hand eczema in relation to occupational exposure from cement was 7.1 % in males and 30% in females (overall 9.2%) compared to other occupational exposures in 7810 people with hand eczema. Burrows and Calnan estimated that about 200,000 workdays were lost each year in the building
0-8493-7362-X/00/$0.00+$.50 © 2000 by CRC Press LLC
industry through eczema.9 In Singapore, it was estimated that about 14,000 workdays per year were lost through occupational eczema in the construction industry.10
